- …AI, intelligent automation, and workflow orchestration. Position Summary As our Analyst , Payer Accountability, you will educate internal operating teams ... to understand and navigate payer guidelines. Every day you will research and interpret...guidelines. Every day you will research and interpret complex customer/ payer contract terms in order to identify and escalate… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our R37 GenAI Lab Process Analyst in the Perfect Claim pillar, you will play a key role in both ... enabled product platform. **Here's what you will experience working as a Process Analyst :** + Analyze and optimize current edits in claim scrubbers to improve claim… more
- Henry Ford Health System (Troy, MI)
- Reporting to the CDM Manager, the CDM Analyst is responsible for supporting and maintaining the Charge Description Master (CDM), including being responsible for the ... accuracy and completeness of the CDM. The CDM Analyst also supports the CDM Coordinator and Senior CDM...accurate CPT/HCPCS codes and revenue codes based upon multiple payer requirements. 13.Adheres to HELIOS Service Level Agreements related… more
- Henry Ford Health System (Detroit, MI)
- …PRINCIPLE DUTIES AND RESPONSIBILITIES: 1. Responsible for building basic payer /plan-specific contract terms, including common reimbursement methodologies. 2. Achieve ... and analyzing issues for areas of opportunities. 6. Escalate payer contract non-compliance issues to contract administrators/consultants EDUCATION/EXPERIENCE REQUIRED:… more
- Molina Healthcare (Warren, MI)
- …acceptable. **REQUIRED EXPERIENCE:** + 1-3 years of experience in Healthcare ( payer experience), Vendor Management, Data Analytics, Contract Terms and Conditions, ... Procurement, Project Management, or Account Management + Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas. + Proficient with Microsoft Office Suite, databases, advanced spreadsheets, pivot… more